闪光视觉诱发电位在垂体瘤手术中的应用  

Application of flash visual evoked potential in hypophysoma surgery

作　　者：汤冉冉 任尚军 李鑫[1] Tang Ranran;Ren Shangjun;Li Xin(Department of Neurosurgery,Liaocheng Brain Hospital,Liaocheng City,Shandong Province,252000,China)

机构地区：[1]聊城市人民医院东院区脑科医院神经外科,山东省聊城市252000

出　　处：《现代电生理学杂志》2023年第1期10-14,共5页Journal of Modern Electrophysiology

摘　　要：目的 探讨术中闪光视觉诱发电位(FVEP)在内镜下垂体瘤切除术中的应用价值。方法 回顾性分析2020年6月至2021年12月聊城市人民医院神经外科收治的术中行FVEP监测的内镜下垂体瘤切除术患者80例,及2019年1月至2020年6月未行FVEP监测的内镜下垂体瘤切除术患者74例的临床资料。通过比较两组患者术前术后视力视野的变化情况,评估术中FVEP监测在垂体瘤切除术中的应用价值。结果FVEP监测组3例患者于术中发现A1、A2波幅值波幅下降超过50%时,及时通知术者,细化操作步骤,减轻对视交叉的机械牵拉,波幅有了部分恢复,至术后波幅未再明显降低。FVEP监测组术后视力视野改善率为58.8%,非FVEP监测组改善率为47.3%,差异具有统计学意义(P<0.05)。术后两组患者视力视野损害评分均降低,且FVEP监测组低于非FVEP监测组(P均<0.05)。结论 术中FVEP监测在垂体瘤切除术中可以明显改善视力视野损害情况。Objective To evaluate the application of intraoperative flash visual evoked potential(FVEP) in endoscopic pituitary adenoma resection. Methods The clinical data of 80 patients with endoscopic pituitary adenoma resection who underwent intraoperative FVEP monitoring in Department of Neurosurgery, Liaocheng People’s Hospital from June 2020 to December 2021 and 74 patients with endoscopic pituitary adenoma resection who did not undergo FVEP monitoring from January 2019 to June 2020 were retrospectively analyzed. To evaluate the value of intraoperative FVEP monitoring in pituitary adenoma resection by comparing the changes of visual acuity and visual field between the two groups before and after surgery. Results In the FVEP monitoring group, when the amplitude of A1 and A2 decreased by more than 50% during the operation, the operator was informed in time and the operation steps were refined to reduce the mechanical traction of the optic chiasm, and the amplitude was partially recovered until the postoperative amplitude did not decrease significantly. The improvement rate of postoperative visual acuity and visual field was 58.8% in the FVEP monitoring group and 47.3% in the non-FVEP monitoring group(P<0.05). The visual acuity and visual field damage scores in the two groups were decreased after the operation, even lower in the FVEP monitoring group(all P<0.05). Conclusion Intraoperative FVEP monitoring can significantly improve visual acuity and visual field damage during pituitary adenoma resection.

关 键 词：诱发电位 视觉 垂体肿瘤 视觉障碍 

分 类 号：R736.4[医药卫生—肿瘤]